title: Laparoscopic liver resection for hepatocellular carcinoma.
abstract: OBJECTIVE
  To provide an updated review on the clinical experience in laparoscopic liver resection, specifically for hepatocellular carcinoma.
  
  
  METHODS
  A comprehensive literature search in MEDLINE was conducted for all English papers up to May 2010 on laparoscopic liver resection for hepatocellular carcinoma. Patient characteristics, perioperative results, and oncologic outcomes were compared and analysed.
  
  
  RESULTS
  We analysed 11 clinical studies involving 466 hepatocellular carcinoma patients treated with laparoscopic hepatectomy. Thirty-seven (9%) patients underwent major resection. Cirrhosis occurred in 62%. The mean operative time was 189.5 min, and the mean blood loss was 315.6 mL. Blood transfusion was required in 14.6% of patients. There were two operative deaths. Postoperative complications included bile leakage (1%), bleeding (2.9%), liver failure (5.1%), and ascites (6%). The 1-year, 3-year, and 5-year disease-free survival rates ranged from 60% to 90%, 50% to 64%, and 31% to 50%, respectively, and the corresponding overall survival rates ranged from 85% to 100%, 67% to 100%, and 50% to 97% respectively.
  
  
  CONCLUSIONS
  Laparoscopic liver resection for hepatocellular carcinoma appears to be safe and to achieve acceptable oncologic outcomes even in cirrhotic livers, but whether it is comparable to conventional open surgery needs to be evaluated in a randomized, controlled trial setting.
authors.affiliation: Department of Surgery, The University of Hong Kong, Hong Kong SAR.
authors.forename: Carmen D
authors.initials: CD
authors.lastname: Chung
authors.forename: Lydia L
authors.initials: LL
authors.lastname: Lau
authors.forename: Kwan Lung
authors.initials: KL
authors.lastname: Ko
authors.forename: Andrew C
authors.initials: AC
authors.lastname: Wong
authors.forename: Shezam
authors.initials: S
authors.lastname: Wong
authors.forename: Albert C
authors.initials: AC
authors.lastname: Chan
authors.forename: Ronnie T
authors.initials: RT
authors.lastname: Poon
authors.forename: Chung Mau
authors.initials: CM
authors.lastname: Lo
authors.forename: Sheung Tat
authors.initials: ST
authors.lastname: Fan
mesh_terms: D006528:Carcinoma, Hepatocellular / Q000401:mortality / Q000601:surgery*; D018572:Disease-Free Survival; D005260:Female; D006498:Hepatectomy / Q000706:statistics & numerical data*; D006801:Humans; D010535:Laparoscopy / Q000706:statistics & numerical data*; D008103:Liver Cirrhosis / Q000150:complications; D008113:Liver Neoplasms / Q000401:mortality / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D015996:Survival Rate; D016896:Treatment Outcome